What you need to know about cannabis topicals

As stocked as the shelves have been for cannabis consumers in Canada, or the e-shelves if you’re in Ontario, you won’t find a product that is gaining traction in the cannabis community: topicals.

These ointments or creams are known to assist some sufferers of chronic pain such as nerve damage. But Canada won’t allow cannabis topicals into the recreational market for another year, until these products are approved by Health Canada. Currently, only approved medical cannabis users can receive a prescription for cannabis topicals.

How do these topicals work? The human body naturally interacts with cannabis via a system of receptors called the endocannabinoid system, and it thrives in our brains, as well as throughout our nervous systems. Humans all have receptors ready to interpret the cannabis plant’s chemical compounds, or cannabinoids.

“These receptors aren’t all in our heads,” Dr. Selman Holden, a Harvard-trained family physician in Maine, told reporters.1 “We’ve got them all over our body. So, when cannabis is applied locally to an area of discomfort, say an achy joint, then the CB1/2 receptor system does its anti-inflammatory or pain work there, along with releasing endogenous opioids.”

She added that because of how these creams are applied, cannabis topicals are unlikely to get someone high.

“If it was applied to our mucosal tissues, like our mouth — maybe for a cold sore/herpes blister — or for a hemorrhoid, then there’s a better chance, but usually so little is used, and it’s not usually highly concentrated cannabis oil,” she said.

Cannabis topicals may not be legal but that hasn’t stopped Canadian dispensaries from stocking a variety of ointments. At a cannabis-friendly farmer’s market in Toronto in early 2018, several vendors openly sold cannabis creams that were available to not just medical-cannabis cardholders, but also to recreational users.

As with much of cannabis science, there are still many hypotheticals and theoretical ideas regarding topicals. It’s been difficult for scientists to study the medicinal uses of cannabis as it’s applied to the skin due to decades of the U.S. and Canada being stymied to research the plant in a concerted manner.

A Canadian topical maker wants to change that. Joseph Gabriele is the CEO of Delivra, a biotech company focused on creating topical delivery platforms. They created a cannabis topical that is currently being used by physicians in clinics, and their products are available in Canada via a medical cannabis prescription.

Patients may prefer topicals over other products because they want “a predictable outcome,” says Gabriele in an interview. “When you ingest something like a cannabis edible, or smoke a joint, your body metabolizes the cannabis and your body is different than mine so there could be a lot of variability in the response to cannabis. And a cannabis brownie, say, might have a lot of concentration of cannabis in one corner of the brownie compared to another. It’s difficult to get consistency in an edible.”With a cannabis topical, though, Gabriele says the patient gets a “more sustained effect and more bang for their buck.”

Making these drugs work by applying them to the skin requires a deep knowledge of transdermal science. An article in The Cannabist explains that if the skin’s outter layer is penetrated by a carrier substance in the patch, then the Active Pharmaceutical Ingredient (API), such as cannabis, can be circulated into the bloodstream. Permeation enhancers can be liposomes, fatty acids, terpenes, etc.

But once it works, Gabriele says, it works extremely well, with a one-gram dosage affecting the body for 10-to-12 hours.

Cannabis topicals have become quite popular in the U.S. even with the celebrity set, who praise their therapeutic value: Actor Patrick Stewart revealed2 in 2017 that he uses cannabis creams to ease the pain of his arthritis symptoms.

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Lynn Wells only nibbles on a cannabis brownie monthly(,) but she’s one of many Canadian seniors clamouring to a plant they tried decades ago and have now returned to in light of some aches, pains and other conditions.

The endocannabinoid system is found in all vertebrate animals and even some invertebrates are reported to have an ECS. According to some reports, the number of endocannabinoid receptors in the human body is greater than all of the other neuromodulatory systems combined, including serotonin and dopamine. In other words, the endocannabinoid system is critically important to maintaining health and homeostasis.

For two particular reasons, there are few topics being explored in the cannabis space more
exhilarating than the endocannabinoid system. First, for a lack of research in the area, medical
schools have almost exclusively omitted the system from the curriculum. Second, as drug
policies have evolved, researchers have been allowed to study the system, and its inherent
connection to cannabinoids found in the cannabis plant.

As medical cannabis has gained acceptance as a viable treatment option over the past two decades,
so too has the list of symptoms the plant has been shown to help grown. No longer is the plant merely
used to treat chronic pain or extreme conditions like HIV/AIDS, it now complements nearly every
therapy option available.

When discussing cannabis, it is important to remember that the line between science and folklore
can at times be fickle. In the context of cannabis as a treatment, for instance, there is only one
direct scientific source (THC found in ashes) that cannabis was used as a medicine, around 400
AD.

The decision to adopt cannabis as a treatment option is, like most significant changes in life, very
personal. Whether you’ve decided to incorporate medical cannabis into your routine to treat
chronic pain, sleep issues, cancer symptoms or social anxiety, you’ve likely done so primarily
for one reason: to feel better.

Can cannabis cure cancer? To date, there is no scientific evidence to back the theory that
cannabis kills cancer cells. In fact, most responsible cannabis professionals – leery of a culture of
misinformation – will caution patients to ignore that claim.

There are few experts, if any, on the research and development side of the cannabis conversation that deny the holistic efficacy of THC. Despite there being a common misperception that the most popular and notorious of all the cannabinoids in the cannabis plant is only responsible for a good time, there is a wealth of scientific data that refutes this assertion. In fact, insiders have known – long before medical cannabis became an acceptable adjunct treatment option – that THC has profound therapeutic benefits.

The list of sophisticated new cannabis products lining product shelves of this new space is extensive, and impressive. More often than not, these products serve as a responsible introduction to medical cannabis. Where pipes and bongs have a tendency to lend stereotype to any conversation of cannabis therapy, new delivery methods like oils, edibles and topicals tend to have exactly the opposite effect.

Cannabis treatment is a moot therapy option without a firm grasp on how to dose. This very fact has perhaps been best illustrated by the fact the medical community, until recently, has shied away from throwing full support behind the plant and its potential. However, as new products develop, and fresh ways of dosing have become available to patients, so too have the means of dosing surfaced. As a result, more and more practitioners have started prescribing cannabis- based concentrates.